In Reply Dr Brem believes our findings—that computer-aided detection (CAD) does not improve diagnostic accuracy of mammography—are curious and “incongruent with the overwhelming majority of peer-reviewed, published studies on the topic.” Her perspective is puzzling and ignores the large meta-analysis of 10 CAD studies which found that CAD significantly increased recall rates (and thus false-positive examinations) with no significant improvement in cancer detection rates compared with readings without CAD.1